President Donald Trump’s administration has decided not to cover expensive, high-demand obesity treatments under the federal government’s Medicare program.
The Centers for Medicare and Medicaid Services said late Friday that it would not cover the medications under Medicare’s Part D prescription drug coverage. Medicare covers health care expenses mainly for people age 65 and older.
Trump’s predecessor, Joe Biden, proposed a rule in late November after Trump won reelection that would have extended coverage of drugs like Zepbound and Wegovy. The rule was not expected to be finalized until Trump took office.
Trump returned to office in January. The Senate confirmed Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services on Thursday.
CMS did not offer an explanation Friday for its decision, and federal spokespeople did not immediately respond to requests for comment.
Trump’s Health and Human Services secretary, Robert F. Kennedy Jr., has been an outspoken opponent of the injectable drugs, which have exploded in popularity due to the potentially life-changing weight loss that some patients experience.
Polls show Americans favor having Medicaid and Medicare cover the costs. But many insurers, employers and other bill payers have been reluctant to pay for the drugs, which can be used by a wide swath of the population and can cost hundreds of dollars a month.
Biden’s proposal was expensive: It would have included coverage for all state- and federally funded Medicaid programs for people with low incomes, costing taxpayers as much as $35 billion over next decade.
Proponents of the coverage have argued that treating obesity can actually reduce longer-term costs by cutting down on heart attacks and other expensive health complications that can arise from the disease.
The benefits consultant Mercer has said that 44% of U.S. companies with 500 or more employees covered obesity drugs last year.
Medicare does pay for drugs like Wegovy for patients who have heart disease and need to reduce their risk of future heart attacks, strokes and other serious problems. The federal program also covers versions of the drugs that treat diabetes.
More than a dozen state Medicaid programs already cover the drugs for obesity.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
—Tom Murphy, AP Health Writer
